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Title: Studies on diverticular disease of the colon and motility disorders of the ano-rectum
Author: Smith, Adam N.
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 1995
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This thesis examines aspects of distal bowel function, principally by the registration of intra-luminal pressure. High fibre diets lowered the pressure in diverticular disease and reproduced the effect of operations. Fibre became a tool in elucidate the diverticular disease defect. Coarse bran was more effective than fine bran, possibly by enhancing faecal bulk, or by the mechanical effect of particle size. This action was also true of coarser wheat, and was found in a rural more than an urban community. Pressure and transit were often inversely related. The reason for the thickened smooth muscle and raised pressure in diverticular disease was sought in release of GI hormones and the smooth muscle stimulating properties of bile acids and prostaglandins. Weakness of the colon wall was reflected in increased compliance. The tensile strength of the colon was reduced with age, but remained high in Africans who have a high fibre intake, but no diverticular disease. The collagen fibril size was changed in the colon wall particularly in the sigmoid colon where the intra-luminal pressure is highest and most of all in diverticular disease. The condition may owe its origin to chronic under-filling of the colon and this may be the means through which fibre reverses the aetiological factors. Pressure studies were also applied to ano-rectal functional disorders along with newer methodology, such as the measurement of the pudendo-anal reflex. Neural factors were found as aetiological mechanisms in faecal incontinence, severe constipation and radiation damage. The effects of operations for radiation damage were assessed. A stimulator acting by repetitive bombardment of the pudendo-anal reflex was devised to treat faecal incontinence and the improved pressure and proctographic changes produced were recorded.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Sc.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available